For many years we were aware of a consistent connection between the perfectionist tendency and the development of TMS. Though some of our patients denied being perfectionists, they admitted to being hardworking, conscientious, responsible, driven, success-oriented, perpetual seekers of new challenges, sensitive to criticism, and their own severest critics. But it was a long time before I realized that the drive to be good could be equally enraging to the child-primitive. It is yet another pressure. Though both the perfect and the good tendencies are present in most patients I see, the good is
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